Abstract
Background: Tuberculosis (TB) has been reported to increase morbidity after kidney transplantation and pose a therapeutic challenge. However, population-based research, specifically focused on the association between kidney transplantation and subsequent pulmonary or extrapulmonary TB, is lacking. Methods: A nationwide population-based study was conducted using Taiwan's National Health Insurance Research Database, which provided claims data belonging to kidney transplant recipients during 1997-2006. Multivariate analysis was used to identify independent risk factors for TB after kidney transplantation. Kaplan-Meier survival analysis was used to assess the outcome of patients with TB. Results: Among 4554 kidney transplant recipients over the 10-year period, 109 (2.4%) patients with newly diagnosed TB were identified: 75 patients with only pulmonary involvement, and 34 with extrapulmonary spread. The incidence of kidney transplant recipients developing TB was 638 per 100,000 person-years. The independent risk factors for post-transplant TB included cyclosporine-based immunosuppressant agents during the first year after kidney transplantation (odds ratio [OR]: 1.98, P = 0.001), hepatitis C infection (OR: 1.79, P = 0.024), and chronic obstructive pulmonary disease (OR: 1.50, P = 0.041). Kidney transplant recipients who developed TB had a lower 5-year survival rate than those who did not (78.6% vs. 93.4%, P = 0.001). Conclusions: Kidney transplant recipients in Taiwan did have a high risk of TB infection, with high proportion of extrapulmonary spread. Physicians need to be vigilant in surveying for TB in kidney transplantation, especially in high-risk patients.
| Original language | English |
|---|---|
| Pages (from-to) | 502-509 |
| Number of pages | 8 |
| Journal | Transplant Infectious Disease |
| Volume | 14 |
| Issue number | 5 |
| DOIs | |
| Publication status | Published - Oct 2012 |
| Externally published | Yes |
Fingerprint
Keywords
- Chronic obstructive pulmonary disease
- Extrapulmonary tuberculosis
- Hepatitis C
- Immunosuppressants
- Kidney transplantation
- Pulmonary tuberculosis
ASJC Scopus subject areas
- Transplantation
- Infectious Diseases
Cite this
Impact of pulmonary and extrapulmonary tuberculosis infection in kidney transplantation : A nationwide population-based study in Taiwan. / Ou, S. M.; Liu, C. J.; Teng, C. J.; Lin, Y. T.; Chang, Y. S.; Chiang, S. C.; Tzeng, C. H.; Chen, T. J.
In: Transplant Infectious Disease, Vol. 14, No. 5, 10.2012, p. 502-509.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Impact of pulmonary and extrapulmonary tuberculosis infection in kidney transplantation
T2 - A nationwide population-based study in Taiwan
AU - Ou, S. M.
AU - Liu, C. J.
AU - Teng, C. J.
AU - Lin, Y. T.
AU - Chang, Y. S.
AU - Chiang, S. C.
AU - Tzeng, C. H.
AU - Chen, T. J.
PY - 2012/10
Y1 - 2012/10
N2 - Background: Tuberculosis (TB) has been reported to increase morbidity after kidney transplantation and pose a therapeutic challenge. However, population-based research, specifically focused on the association between kidney transplantation and subsequent pulmonary or extrapulmonary TB, is lacking. Methods: A nationwide population-based study was conducted using Taiwan's National Health Insurance Research Database, which provided claims data belonging to kidney transplant recipients during 1997-2006. Multivariate analysis was used to identify independent risk factors for TB after kidney transplantation. Kaplan-Meier survival analysis was used to assess the outcome of patients with TB. Results: Among 4554 kidney transplant recipients over the 10-year period, 109 (2.4%) patients with newly diagnosed TB were identified: 75 patients with only pulmonary involvement, and 34 with extrapulmonary spread. The incidence of kidney transplant recipients developing TB was 638 per 100,000 person-years. The independent risk factors for post-transplant TB included cyclosporine-based immunosuppressant agents during the first year after kidney transplantation (odds ratio [OR]: 1.98, P = 0.001), hepatitis C infection (OR: 1.79, P = 0.024), and chronic obstructive pulmonary disease (OR: 1.50, P = 0.041). Kidney transplant recipients who developed TB had a lower 5-year survival rate than those who did not (78.6% vs. 93.4%, P = 0.001). Conclusions: Kidney transplant recipients in Taiwan did have a high risk of TB infection, with high proportion of extrapulmonary spread. Physicians need to be vigilant in surveying for TB in kidney transplantation, especially in high-risk patients.
AB - Background: Tuberculosis (TB) has been reported to increase morbidity after kidney transplantation and pose a therapeutic challenge. However, population-based research, specifically focused on the association between kidney transplantation and subsequent pulmonary or extrapulmonary TB, is lacking. Methods: A nationwide population-based study was conducted using Taiwan's National Health Insurance Research Database, which provided claims data belonging to kidney transplant recipients during 1997-2006. Multivariate analysis was used to identify independent risk factors for TB after kidney transplantation. Kaplan-Meier survival analysis was used to assess the outcome of patients with TB. Results: Among 4554 kidney transplant recipients over the 10-year period, 109 (2.4%) patients with newly diagnosed TB were identified: 75 patients with only pulmonary involvement, and 34 with extrapulmonary spread. The incidence of kidney transplant recipients developing TB was 638 per 100,000 person-years. The independent risk factors for post-transplant TB included cyclosporine-based immunosuppressant agents during the first year after kidney transplantation (odds ratio [OR]: 1.98, P = 0.001), hepatitis C infection (OR: 1.79, P = 0.024), and chronic obstructive pulmonary disease (OR: 1.50, P = 0.041). Kidney transplant recipients who developed TB had a lower 5-year survival rate than those who did not (78.6% vs. 93.4%, P = 0.001). Conclusions: Kidney transplant recipients in Taiwan did have a high risk of TB infection, with high proportion of extrapulmonary spread. Physicians need to be vigilant in surveying for TB in kidney transplantation, especially in high-risk patients.
KW - Chronic obstructive pulmonary disease
KW - Extrapulmonary tuberculosis
KW - Hepatitis C
KW - Immunosuppressants
KW - Kidney transplantation
KW - Pulmonary tuberculosis
UR - http://www.scopus.com/inward/record.url?scp=84867641105&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84867641105&partnerID=8YFLogxK
U2 - 10.1111/j.1399-3062.2012.00737.x
DO - 10.1111/j.1399-3062.2012.00737.x
M3 - Article
C2 - 22571347
AN - SCOPUS:84867641105
VL - 14
SP - 502
EP - 509
JO - Transplant Infectious Disease
JF - Transplant Infectious Disease
SN - 1398-2273
IS - 5
ER -